There have been a few changes in my world lately. For one thing, I seem to be getting to the bottom of my health issues. Friends and regular readers may be aware that I've been unwell for a couple of years, going back to when I was diagnosed with two strains of atypical pneumonia and glandular fever. At the time, the doctors also found that my calcium levels were too high, my Vitamin D levels were too low, there were indications of lupus, thyroid problems and osteopenia. A specialist also found a hiatus hernia, reflux or GERD and oesophagitis. To my huge disappointment, it seemed that my entire system had virtually crapped itself. Regretfully, I had to take months off work from a job that I absolutely loved... and this was not a great lead into my planned retirement!

While Peter's mother, Joan, was visiting recently, my persistent cough worsened to the point that it was uncontrollable. It was during this time that Joan mentioned that, like myself, she takes medication for reflux and noted that she also has a cough that won't go away.

The penny dropped!

You see, we'd treated Joan to high tea and all kinds of other culinary outings, and my cough seemed to get unbearably worse after I'd consumed certain foods and beverages. In fact, while talking on the phone with a friend, I noticed that I hadn't been coughing at all until after I'd eaten two chocolate wheaten biscuits.

I booked an appointment with my GP and, in the meantime, consulted a couple of medical books, and also jumped online to do a little research. To my amazement, I learned that some people with reflux and hiatus hernia can have laryngopharyngeal reflux (LPR) or 'silent reflux', the symptoms of which include hoarseness, chronic throat clearing, chronic coughing, difficulty swallowing and breathing, a constant 'lump in the throat', unexplained vomiting and chest pain, among other things. As I understand it, these issues are caused by acidic juices backing up from the stomach into the oesophagus and throat, thus causing irritation from the digestive enzyme known as pepsin.

On reflection, I was reminded that in 2013, the specialist gastroenterologist had advised me not to eat too many red capsicums and suggested I look at the FODMAP eating plan, but he didn't really elaborate and at the time I didn't make too many drastic changes to my diet.

LPR is referred to as 'silent reflux', because it can be present without any feelings of heartburn or with only very mild symptoms. In a small number of cases, the condition may be more severe and can cause major complications, such as pneumonia (!!). More alarmingly, it can also lead to cancer.

A lengthy consultation with my GP confirmed my suspicions and, thankfully, I've now been referred to an ENT specialist. I discussed an 'acid-free', low fat elimination eating plan with my doctor and he agreed that it was a sensible approach. My daily dose of Nexium has also been slightly increased for the time being (and he mentioned the possibility of surgery - ugh). My preference is to manage and calm my symptoms through a revised diet, if possible. This won't be the first time that I've adopted lifestyle and dietary changes to improve my health and wellbeing.

As such, I'm eating smaller meals, and don't eat anything for three hours before bedtime, as this is when my symptoms are worse. Indeed, it explains me waking up with a sore throat and chest, and 'flu-like' symptoms for so many, many months. Using this list as a basic guide, I'm avoiding all caffeine, alcohol, chocolate, citrus, mint, carbonated drinks, and gluten; as well as all fatty, highly acidic and overly spicy foods.

Some of my favourite things are to be eliminated, at least for now. To help monitor my progress, I'm keeping a food diary. Frankly, I miss eating fruit, and drinking fizzy water and wine. Fortunately, I can tolerate pears and watermelon, and there are plenty of other foods that I can enjoy. Peter is voicing his disappointment at the fact that I'm avoiding so many of the foods that I love. But if I'm to get well, I simply must do this. Of course, he is not missing out, as I will happily prepare individual meals for the both of us... e.g. chillies for him, none for me. Things won't change too much here, on this little journal, but I do plan to keep you posted, particularly those who are interested.

Two weeks into it and I'm already seeing results. The cough has all but stopped and I have much more energy. There's a distinct pattern forming, in that if I consume even small amounts of food or drink that I should be avoiding, the hoarseness and phlegmy throat clearing returns. Given that my GP confirmed the specialist's findings from 2013, I feel assured in the knowledge that none of this is psychosomatic and so I will continue with the revised eating program.

Some might wonder why I am sharing this information here on a web site that celebrates food. My response is that sometimes too much of a good thing can be bad for us. I'm living proof of that. Also, for far too long I've been under the impression that the symptoms I've been experiencing are due to viruses or bacterial infections. Case in point, when I mentioned the chronic cough to a GP I saw about a rash on my face a couple of months ago (not my usual doctor), he did not look into my medical history. Instead, he suggested an old fashioned cough remedy from the pharmacy. And this wasn't the only time the diagnosis may have been overlooked. If this can happen to me, it can happen to others.

I am keen to get back to the good health and vitality that I've enjoyed for most of my life, slowly but surely and under medical supervision. If that means eliminating foods that may be 'harmful' to my condition, then so be it.

Important:This article details my own personal experience with silent reflux. It has been shared for informational and educational purposes only. The information should not been seen or taken as medical advice under any circumstances. It goes without saying that you must consult your own physician or medical practitioner if you have any concerns about your health.

so so glad to see you are getting on top of this at last!
I very much hope that you will eventually be able to reintroduce some of the foods you love most, even if you have to have them in moderation (as you know, I do too for other reasons).

Wishing you the best of health and quality of life, my friend xoxoxo

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Lizzy

2/3/2015 02:13:37 pm

Thanks ever so much, Viviane... truly grateful for your support and friendship... good health and a sweet life to you also my friend xoxo

I have had similar symptoms and change of diet has helped enormously I had to drop my morning porridge and my late night tea and toast and with the help of medications the discomfort has eased thank God but it lasted for months before one doctor suggested reflux no more overly spicy food and smaller meals it takes time and patience.

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Lizzy

3/3/2015 07:15:00 am

Hi Sue, it's hard dropping some of our favourite foods and beverages, but easing the discomfort makes it so much better, doesn't it.

yes but I found lighter replacements but the coughing was the worst part I was convinced I had lung problems but the ex Rays were clear had you had the pain in the chest which I was convinced was a heart attack I now know that's part of the symptoms I feel so much better but I still have to be careful what I eat wonder what's next .

colleen

2/3/2015 05:48:37 pm

Hi lizzy
I have some of your issues... hiatus hernia and occasional silent reflux when the hh is disturbed.
I've dropped tea as well. Loving tap water! & have just learnt the hard way that if you are in hospital ask them to choose carefully your post-surgery antibiotic brand as some can upset. Just been there/done that (keflex) .. The vomiting that results makes hh play up, requiring more nexium... and HURTS!

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Lizzy

3/3/2015 07:14:01 am

Hi Colleen, so many people seem to suffer this way... and yes, tap water is a good thing! Thanks for the tip about the antibiotics! Much appreciated.

I am so happy to hear you are getting good results, although I can only imagine how hard it must be to eliminate some of your favorite things from your diet. I hope that, with some careful dieting, you can get the silent reflux under control and begin to add back your favorite and good things in moderation. Big hugs from Tucson!

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Lizzy

3/3/2015 07:15:42 am

Thanks so much, David... all good things in moderation indeed... I learned the hard way. Thanks for the hugs, much appreciated. x

Hi Liz, Very interesting. Have you bought the FODMAP booklet? Just in case you didn't know, you can buy it online from Monash University. If not, how did you work out what and what not to eat? According to the booklet once you know what you are sensitive to you should avoid all those foods for a while and then slowly introduce foods back in your diet.

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Lizzy

3/3/2015 07:18:32 am

Hi Glenda, yes I managed to track down info about the FODMAP diet in 2013.... about 12 years ago I was unwell (in other ways) and saw a specialist and then stuck to a strict elimination diet (low fat and no grains). The way these things work is that you go onto a very 'clean' diet of simple vegetables, bland meat/fish dishes, rice and fruits such as pears, and then you slowly reintroduce different foods... as I mentioned in the post, the results are quite remarkable, in that almost immediately I am hoarse (or coughing!) again. This way I can tell what sets things off, and avoid those things.

My, but I am sorry to hear all of this. I know many people who are in the same boat as you. Their stories are just the same as yours. For all of them it took a few months to get everything under control. but now they are back to their old selves and feeling "like a million bucks" as one friend put it or "like my old self" as another remarked. I know it can be depressing and terribly restrictive when one must avoid so many food items, but do stick with it. The rewards of good health are well worth the sacrifice. I bet you will find that, over time, you will enjoy far better quality sleep, and in turn you will feel better and have an enhanced sense of well being. So go with the doctor's orders, esp. the one about avoiding food for several hours prior to bedtime. Everyone said that one made all the difference in the world. Be well, my friend!

P.S. You are in good company. President Obama was diagnosed with LPR in December of 2014. He had complained of a persistent sore throat.

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Lizzy

3/3/2015 07:20:17 am

Hi Adri, thanks so much for your input. It seems that there are indeed many sufferers out there, which is why I 'put pen to paper' on my experiences, so to speak. Definitely not eating anything for three hours before bed is helping, as has raising the head end of the bed and changing to higher pillows. I heard about the President... good company indeed!

One of my sister's experienced something similar to your symptoms. For about a year she essentially avoided acids (tough because she loves tomatoes), chocolate (ditto!), spicy stuff (ditto!), and many of the foods you mentioned. Her symptoms went away, and today she can enjoy all the foods she avoided -- although in moderation. Good luck with your journey!

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Lizzy

3/3/2015 07:22:49 am

Hi John, yep, seems we all know someone who suffers reflux in its many forms. Silent reflux seems particularly bad as one doesn't feel the heartburn, per se, just the irritating cough etc... that's when the damage is done. Hopefully my ENT and won't find anything nasty when he/she investigates. Thanks for your good wishes!

Interesting Lizzy - I have had a persistent cough for months and have recently stopped taking one of my medications and it is getting better along with some other problems I am having. I am finding doctors are asking me "what do you think is wrong?" - have had this from my GP and a specialist in the last couple of months - so take that as a sign they are expecting us to be self-diagnosing.!

Sorry to hear of your woes, Liz. I am something of a reluctant expert on gastric reflux as both my younger children suffered it to an extreme. My youngest had silent reflux which I wouldn't have spotted if I hadn't already been through hell with my son. Both kids had serious respiratory problems and were on medication from the age of just a few weeks, which in itself caused issues for my son. They both ended up having major abdominal surgery when they were 6 and 3 respectively. My son is quite good now, but my daughter has all her symptoms back and is on major doses of medication and carries Mylanta tabs with her everywhere. It's a tough gig.

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Lizzy

3/3/2015 04:04:24 pm

Amanda, that is really tough... I feel for both your children... and you... silent reflux is a horrible thing, really.... so glad you picked it up.

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Jenny

3/3/2015 09:15:51 am

I've noticed I'm "uncomfortable" after eating certain foods too, so I read your article from top to bottom with extreme interest. Thanks for bringing silent reflux to our attention.

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Lizzy

3/3/2015 04:04:50 pm

You are welcome, Jenny. If you have any concerns, please do see your GP.

G'day Hope you continue on your road to recovery Lizzy and the medical system as a whole in my opinion is shocking as more doctors seem to be focusing on their "time allotment" and their efficiency ratings rather than what they actually went into medicine for...which was to help people. Cheers! Joanne

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Lizzy

3/3/2015 04:05:23 pm

Not so with my GP, Joanne... but I am disappointed that none of the GPs at my local clinic have picked this up sooner!

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Eha

3/3/2015 01:25:00 pm

'Losec' rather than 'Nexium' . . . Just for a brief time else you want to change your whole gastric mucosa forever!! NO fodmap!! Would I write it down in black-and-white if I did not know or did nor have tertiary education therein! For about 30 years!! Easier to 'shut up' - don't you think!! And I have had to cope with this for some forty years!! 'nuff said!!

I checked out that link Liz and it's so interesting! I'm so glad you've pinned down the problem and hopefully you'll soon see some improvements in your health. I'll definitely try the aloevera as you suggested, and will be very interested to see what the specialist has to say. Good luck! Xo

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Lizzy

3/3/2015 06:37:53 pm

Thanks Bec... do be careful with the aloe vera, as I've since discovered it has citric acid, which is not suitable. Thanks for the chat and your support. Take care too xo

I knew you had some health issues but I had no idea how debilitating and extensive they were. It's amazing just how determined we can be and how utterly able we are to give up those things we love if it will make us better. I'm so sorry you've had to give up carbonated water and wine and chillies as I know those things would be an absolute struggle for me xx

It must be a relief for you to find a diagnosis that makes sense. I agree with you that it is useful to share because I have had those sort of doctor's appts where they just give you the easy option rather than really looking into what might be happening. Good luck with eating your way back to good health - I hope that it is not a long term diet.

I am a great believer that food is medicine. For years I suffered with reflux, had to avoid foods and was on a daily dose of Somac to control the symptoms. I tried more than once to stop the tablets but the pain always drove me back.
Two years ago I started introducing fermented foods to my daily diet. Within months I was able to stop all medication and now can pretty much eat anything I want. I haven't taken medication since.
I try to eat or drink something fermented every day, and if I am traveling I also carry a good probiotic with me that I take daily. Occasionally, particularly if I eat something very spicy, I get a little uncomfortable so I just pop extra probiotics and that sorts it. It might be something additional for you to consider.

Treating symptoms and not causes can lead to all sorts of side effects and unnecessary medication being taken. Please take care of yourself. My Grandfather died from Oesophageal cancer which was awful!

Liz, I'm so sorry to hear about your health woes, but I'm glad you're getting to the bottom of them! I didn't for one minute believe your symptoms were psychosomatic; our bodies try to tell us soooo much, if only we (and our doctors) would listen! Hooray for putting the pieces of the puzzle together, even if it has meant temporary (or lifelong) dietary changes. One of my worst "cough inducers" is dairy... much as I hated figuring that out (and much as I love butter, cheese, heavy cream, etc.) After awhile you get used to the idea... and feeling good far overrides doing without. Best, best wishes to you as you recover, xo.

I had silent reflux for years and as a singer is is very detrimental for the voice... I have been on a very good fermented food regime with as little sugar as possible (you wouldn't know it with my Sunday blog) I also drink about 500ml of water kefir every day and the change has been amazing! It really is a decease that a lot of people don't know about. So thank you for shedding some light on the subject!
I am also glad to hear that it was diagnosed an your health is better! Liz xx

Thanks for your dietary tips on how to reduce LPR related chronic cough. You make a good point about how keeping a food diary can help you identify some foods that are especially guilty at triggering you condition. You make a great point about how you will want to see a doctor or specialist for any additional treatment options for LPR. It often takes a multi-pronged approach to get the best results.